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By Michael Klesius Photographs by Karen Kasmauski



Will a vaccine ever suppress HIV, the elusive virus that has caused immeasurable suffering—and more than 20 million AIDS deaths throughout the world?



Get a taste of what awaits you in print from this compelling excerpt.

On a sweltering morning last February, a stray dog lay panting in the doorway of Clinic 17 of the Bangkok Vaccine Evaluation Group. Inside, the drone of an air conditioner filled an upstairs room where a handful of Thai nurses bustled around a 37-year-old heroin addict on an examination table. Injections had so scarred the veins in his arms that the nurses had turned him onto his stomach to draw blood from a vessel in the back of his knee. As the dark liquid trickled into the syringe the man smiled, baring gray teeth.

“This is going to be very beneficial for society,” he said.

Or so he hopes. His blood, drawn and tested twice a year, is contributing to the worldwide search for a possible preventive vaccine for HIV, the virus that causes the disease AIDS.

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In high-risk groups a predictable percentage of participants—from 1.5 to 6 a year, depending on sexual or drug habits—would be expected to become infected with HIV over the course of a trial, even with thorough counseling in risk reduction. To determine if AIDSVAX, the HIV vaccine, might lower the percentage, follow-up blood testing takes place at six-month intervals. If the vaccine group shows a lower infection rate than the placebo group, there is evidence that the vaccine is working. But we won’t know for certain until the end of the year, when we have results from the first trials, begun in 1998-99, in Europe and North America.

What we do know is that more than 40 million people worldwide carry HIV, although 95 percent of them are never officially diagnosed HIV-positive. Every 24 hours 15,000 more become infected with the virus, while 8,000 others die of the resultant AIDS. And we know that AIDS victims suffer merciless deaths when their disabled immune systems allow otherwise treatable ailments to become fatal.

Get the whole story in the pages of National Geographic magazine.


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MISSED THE PRESS
After our magazine went to press, the United Nations released updated figures showing that 40 million people globally were living with HIV/AIDS at the end of 2001.

Online Extra
Researchers place new urgency on cheaper, more effective ways to treat HIV.

Forum
How can HIV-infected people who are too poor to afford treatment be given a fighting chance against this rapidly spreading and fatal disease? Share your thoughts.





In More to Explore the National Geographic magazine team shares some of its best sources and other information. Special thanks to the Research Division.


Southeast Asia has one of the fastest growing HIV/AIDS populations in the world. But this modern disease is being fought by one of the area’s oldest traditions—Buddhism. Working in local communities from Thailand to Bhutan, monks help form support groups and care for children orphaned or affected by HIV/AIDS. They also teach about the positive affects of meditation and how to avoid high-risk behavior. Their mission is “to bridge the gap between HIV-positive people and the rest of the community and to provide alternatives to conventional methods of treatment,” says Laurie Maund, who heads the Sangha Metta Project, which helps organize the effort.

—Nora Gallagher


The Body
www.thebody.com/index.shtml
Visit this comprehensive resource to find links or information regarding almost any question about HIV/AIDS.

UNAIDS
www.unaids.org/hivaidsinfo/statistics/fact_sheets/index_en.htm
One of the world’s authorities on HIV/AIDS, this joint United Nations program provides epidemiological fact sheets by country.

AIDS Walk
www.gmhc.org/
Learn about the annual AIDS Walk and its sponsor, Gay Men’s Health Crisis, one of the oldest HIV/AIDS organizations in the United States.

Vaccine Trials
www.vaxgen.com/
Find out about the only preventive HIV/AIDS vaccine to reach the final stage of clinical testing.

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Cohn, Jon. Shots in the Dark: The Wayward Search for an AIDS Vaccine. W.W. Norton and Company, 2001.

Schoub, Barry D. AIDS and HIV in Perspective: A Guide to Understanding the Virus and its Consequences, 2nd ed. Cambridge University Press, 1999.

Watstein, Sarah Barbara. The AIDS Dictionary. Facts On File, Inc., 1998.

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Jaret, Peter. “Viruses: On the Edge of Life, On the Edge of Death,” National Geographic (July 1994), 58-91.

Jaret, Peter. “The Disease Detectives: Stalking the World’s Epidemics,” National Geographic (January 1991), 114-140.

Caputo, Robert. “Uganda—Land Beyond Sorrow,” National Geographic (April 1988), 468-491.

Jaret, Peter. “Our Immune System: The Wars Within,” National Geographic (June 1986), 702-735.

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